title: Non-pharmacological aspects of blood pressure management: what are the data?
abstract: Hypertension affects 29% of US adults and is a significant risk factor for cardiovascular morbidity and mortality. Epidemiological data support contribution of several dietary and other lifestyle-related factors to the development of high blood pressure (BP). Several clinical trials investigated the efficacy of non-pharmacological interventions and lifestyle modifications to reduce BP. Best evidence from randomized controlled trials supports BP-lowering effects of weight loss, the Dietary Approaches to Stop Hypertension (DASH) diet, and dietary sodium (Na(+)) reduction in those with prehypertension, with more pronounced effects in those with hypertension. In hypertensive participants, the effects on BP of DASH combined with low Na(+) alone or with the addition of weight loss were greater than or equal to those of single-drug therapy. Trials where food was provided to participants were more successful in showing a BP-lowering effect. However, clinical studies with long-term follow-up revealed that lifestyle modifications were difficult to maintain. Findings from controlled trials of increased potassium, calcium, or magnesium intake, or reduction in alcohol intake revealed modest BP-lowering effects and are less conclusive. The reported effects of exercise independent of weight loss on BP are inconsistent.
authors.affiliation: Renal Section, Medical Service, Veterans Affairs North Texas Health Care System, Dallas, Texas 75216-7167, USA. susan.hedayati@utsouthwestern.edu
authors.forename: S Susan
authors.initials: SS
authors.lastname: Hedayati
authors.forename: Essam F
authors.initials: EF
authors.lastname: Elsayed
authors.forename: Robert F
authors.initials: RF
authors.lastname: Reilly
mesh_terms: D000428:Alcohol Drinking; D002136:Calcium, Dietary / Q000008:administration & dosage; D002986:Clinical Trials as Topic; D004032:Diet; D004039:Diet, Sodium-Restricted; D015444:Exercise; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D008274:Magnesium / Q000008:administration & dosage; D017419:Potassium, Dietary / Q000008:administration & dosage; D015431:Weight Loss
chemical_list: D002136:Calcium, Dietary; D017419:Potassium, Dietary; D008274:Magnesium